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Azymes is an enzymatic combination consisting of two recombinant enzymes derived from the human gut bacterium *Flavonifractor plautii*: FpGalNAc deacetylase (EnzAO1) and FpGalactosaminidase (EnzAO2). This enzyme system is designed to convert blood group A (ABO-A) red blood cells and donor organs (such as lungs, kidneys, and hearts) to the universal blood group O (ABO-O) by removing the terminal A-antigen (N-acetylgalactosamine) from cell surfaces. FpGalNAc deacetylase first deacetylates the terminal N-acetylgalactosamine of the A-antigen to a galactosamine intermediate, which is then cleaved and removed by FpGalactosaminidase, leaving the H-antigen characteristic of O-type blood. This donor-centric desensitization technology is being developed to enable ABO-incompatible organ transplantation and expand the universal donor pool, thereby reducing waitlist times and mortality.
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